Tian Yunhong, Ma Hai, Peng Yong, Li Guanyin, Yang Hongchun
Hepatogastroenterology. 2015 Jan-Feb;62(137):187-9.
BACKGROUND/AIMS: To systematically determine the effect of omental flap in pancreaticoduodenectomy against postoperative complication through metaanalysis of published studies.
Thorough literature search in Ovid-MEDLINE and EMBASE databases was conducted to identify studies whether the use of Omental Flap to prevent postoperative complications. Review of 14 article candidates, identified 4 eligible articles with a total of 2971 patients for meta-analysis. Dichotomous data regarding distinction between omental roll-up and nonmental roll-up were pooled using random effects model to obtain the diagnostic odds ratios and their 95% confidence intervals (CIs).
1129 patients in omental roll-up group, 1842 patients in nonomental group. Omental roll-up during pancreaticoduodenectomy could not prevent postoperative pancreatic fistula (OR=0.81, 95%CI 0.40-1.63, P=0.56). it also could not prevent postoperative intra-abdominal bleeding (OR=0.67, 95%CI 0.28-1.59, P=0.37). We use the sensitivity analysis which found The pancreatic fistula was lower in the nonomental roll-up group than in the omental roll-up group (OR=1.24, 95%CI 1.03-1.50, P=0.02).
The use of omental roll-up could not decrease the risk of pancreatic fistula after pancreaticoduodenectomy. Further randomized controlled trials are needed to identify the effect of omental roll-up technique for pancreaticoduodenectomy.
背景/目的：通过对已发表研究的荟萃分析，系统地确定网膜瓣在胰十二指肠切除术中对术后并发症的影响。
在Ovid-MEDLINE和EMBASE数据库中进行全面的文献检索，以确定使用网膜瓣预防术后并发症的研究。对14篇候选文章进行综述，确定4篇符合条件的文章，共2971例患者进行荟萃分析。使用随机效应模型汇总关于网膜包裹与非网膜包裹之间差异的二分数据，以获得诊断比值比及其95%置信区间（CI）。
网膜包裹组1129例患者，非网膜组1842例患者。胰十二指肠切除术中的网膜包裹不能预防术后胰瘘（OR=0.81，95%CI 0.40-1.63，P=0.56）。它也不能预防术后腹腔内出血（OR=0.67，95%CI 0.28-1.59，P=0.37）。我们进行敏感性分析发现，非网膜包裹组的胰瘘发生率低于网膜包裹组（OR=1.24，95%CI 1.03-1.50，P=0.02）。
胰十二指肠切除术中使用网膜包裹不能降低术后胰瘘的风险。需要进一步的随机对照试验来确定网膜包裹技术对胰十二指肠切除术的影响。
